Provider Demographics
NPI:1518065812
Name:NARASIMHAN, SHOBHA (DDS)
Entity Type:Individual
Prefix:
First Name:SHOBHA
Middle Name:
Last Name:NARASIMHAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 RANGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-2491
Mailing Address - Country:US
Mailing Address - Phone:732-991-7803
Mailing Address - Fax:925-303-2436
Practice Address - Street 1:2219 BUCHANAN RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4200
Practice Address - Country:US
Practice Address - Phone:925-978-9714
Practice Address - Fax:925-303-2436
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3501122300000X
CA64147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist